REPOSSESSION AND/ OR REMARKETING FORM

Please fill out the information on this form and click "submit" to send all info to us.
We will contact you within 24 hours of your request.
Fields marked with an asterick ( * ) are required to be filled in.
Contact Information:
* Name:
Company Name:
Street Address:
City:
State:
Zipcode
* Phone Number:
* Email:
Repossession/
Remarketing Information:
Is the account for:
(choose one)
repossession
remarketing
both
If repossession is it...
(choose one)
voluntary
involuntary
not determined
If remarketing and repossession requested, is ...
(choose one)
the repossession absolute or
an "in-place" sale is possible
Equipment location:
Equipment description:
Has the equipment been deinstalled?
yes no
Are there any deadlines we need to be aware of?
Do we need to wait for expiration of Demand or Redemption letters prior to completing sale?
yes no
Has the equipment been for sale previously?
yes no
Gross balance:
Net balance:
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